Milicic Stanic Branka, Ilincic Branislava, Zeravica Radmila, Milicic Ivanovski Dragana, Cabarkapa Velibor, Mijovic Romana
Department of Medicine, Georgetown University Medical Center, 4000 Reservoir Road, NW, Washington, DC 20057, USA.
University of Novi Sad, Faculty of Medicine, Hajduk Veljkova 3, Novi Sad 21000, Serbia.
Int J Endocrinol. 2022 Nov 7;2022:3804899. doi: 10.1155/2022/3804899. eCollection 2022.
In primary hyperparathyroidism, an increased risk of developing the cardiovascular disease may exist due to increased activity of the renin-angiotensin-aldosterone system. The aim of this study was to evaluate the relationship between parathyroid hormone and aldosterone in patients with primary hyperparathyroidism. The study included 48 patients with primary hyperparathyroidism and 30 healthy subjects who matched age and gender to the study group. This study was conducted at the Center for Laboratory medicine, Clinical center of Vojvodina, Novi Sad, Serbia. In addition to clinical data and laboratory determination of the concentration of total and ionized calcium, phosphorus, measurements of parathyroid hormone, vitamin D, direct renin, and aldosterone were performed by the method of chemiluminescent technology. Compared to the controls, the study group had statistically significantly higher values of aldosterone (=0.028), total calcium (=0.01), ionized calcium (=0.003) and parathyroid hormone ( ≤ 0.001) Serum aldosterone and parathyroid hormone levels were correlated positively in patients with primary hyperparathyroidism (=0.509, < 0.05). A statistically significant positive correlation between renin and parathyroid hormone (=0.688, < 0.05) and renin and calcium (=0.673, < 0.05) was determined in hyperparathyroid patients. In multivariate regression analysis, the strongest predictive variable of aldosterone secretion was parathyroid hormone (=0.011). An independent relationship between parathyroid hormone and aldosterone in patients with primary hyperparathyroidism and the correlation between renin and parathyroid hormone as well as with calcium indicate not only the direct but also the indirect associations between parathyroid hormone and aldosterone in primary hyperparathyroidism. These findings may represent another possible model of renin-angiotensin-aldosterone-induced organ damage.
在原发性甲状旁腺功能亢进症中，由于肾素 - 血管紧张素 - 醛固酮系统活性增加，患心血管疾病的风险可能会升高。本研究的目的是评估原发性甲状旁腺功能亢进症患者甲状旁腺激素与醛固酮之间的关系。该研究纳入了48例原发性甲状旁腺功能亢进症患者以及30名年龄和性别与研究组相匹配的健康受试者。本研究在塞尔维亚诺维萨德伏伊伏丁那临床中心的检验医学中心进行。除了临床数据以及总钙、离子钙、磷浓度的实验室测定外，甲状旁腺激素、维生素D、直接肾素和醛固酮的测量采用化学发光技术方法进行。与对照组相比，研究组的醛固酮（=0.028）、总钙（=0.01）、离子钙（=0.003）和甲状旁腺激素（≤0.001）值在统计学上显著更高。原发性甲状旁腺功能亢进症患者的血清醛固酮和甲状旁腺激素水平呈正相关（=0.509，<0.05）。在甲状旁腺功能亢进患者中，确定肾素与甲状旁腺激素（=0.688，<0.05）以及肾素与钙（=0.673，<0.05）之间存在统计学上显著的正相关。在多变量回归分析中，醛固酮分泌的最强预测变量是甲状旁腺激素（=0.011）。原发性甲状旁腺功能亢进症患者甲状旁腺激素与醛固酮之间的独立关系以及肾素与甲状旁腺激素以及与钙之间的相关性不仅表明了原发性甲状旁腺功能亢进症中甲状旁腺激素与醛固酮之间的直接关联，也表明了间接关联。这些发现可能代表了肾素 - 血管紧张素 - 醛固酮诱导器官损伤的另一种可能模式。
